Thank you for the opportunity to comment on the Regulations for the Licensure of Hospices.  I request that the requirement that the hospice "medical director have admitting privileges at one or more hospices and nursing facilities that provide inpatient services to the hospice program's patients" be removed from the regulations. Most hospitals and facilities have hospitalists and medical directors who provide services to patients, including hospice patients, and have eliminated the role of the attending physician.  Despite this change in roles, the quality of care provided to hospice patients during an inpatient stay has not been not jeopardized, as hospice medical directors are still able to provide valuable input into the patient's inpatient plan of care.